Newsletter
September 10, 2007
Volume 4 Issue 1
In This Issue:
- Wellness Initiatives and the Cost of Healthcare
- What is Wellness?
- Duplicate ID Cards
- Health Benefit Options For: Employees’ Dependents (ages19-25)
- REMINDER: Annual Medicare Part D "Notice of Creditable Coverage"
Printable Archive
September 2007April 2007
March 2007
February 2007
Wellness Initiatives and the Cost of Healthcare:
Why does every medical plan charge people who take care of themselves the same rates as those who don’t? The Blues believe that responsible behavior should cost less, so Blue Cross Blue Shield of Michigan (BCBSM) and Blue Care Network (BCN) have designed plans to reward people who commit to making better health choices. With each plan, employees who make a healthy commitment pay lower out-of-pocket costs.
The concept - Employees taking greater control of their own well-being. That’s the idea behind these Blues’ wellness products:
►BCBSM Healthy Blue IncentivesSM
►BCN Healthy Blue LivingSM
Designed with incentive-based wellness features, these plans reward members with lower copays and deductibles when they become active participants in programs to achieve and sustain healthy lifestyles.
Healthy behavior has a significant impact on health outcomes and costs, so programs designed to keep people healthy will likely provide the greatest return in the long run.
Did you know?
► 20% to 50% of health care costs relate to lifestyle choices such as smoking or obesity.
► Disability and absenteeism can be two to three times the cost of direct medical expenditures.
► 70% of American adults have at least two modifiable risk factors.
► The cost burden tied to poor lifestyles is increasing.
The results - Over time, employers who implement wellness initiatives should receive a return on their investment by incurring lower absenteeism rates and greater productivity due to the improved overall health of their employee groups.
Call your agent for a quote and more information on these Healthy Blue products today!
What is Wellness?
Wellness is a philosophy that engages individuals to proactively reduce lifestyle-related risk factors and eventually lessen their need for reactive health care. Wellness programs empower employees to take responsibility for staying well or improving their health status through self-directed effort.
A good wellness program should provide tools that assess and create awareness of the state of the employees’ health and inform employees about healthy lifestyle choices. These tools should also help maintain or improve employees’ health and help to reduce risks.
Through BCBSM’s Healthy Blue IncentivesSM and BCN’s Healthy Blue LivingSM the Blues provide the following wellness tools:
- Health risk appraisal — An online comprehensive questionnaire that helps members pinpoint specific health issues and risks, and guides them to healthier habits,
- Wellness and disease management interventions — Provides health coaching and educational materials for at-risk members,
- Health screenings — Standard preventive tests that can prevent or lead to early diagnosis of illness,
- Smoking cessation — Partners members with a health coach to help them stop smoking,
- Non-smoking workplace — Frees your workplace from the harmful contaminants caused by tobacco product use,
- Walking WorksSM — Encourages healthier lifestyles through setting and achieving personal walking goals,
- Naturally BlueSM — Offers discounts on vitamins, alternative medicine, fitness centers, health and wellness magazine subscriptions and more.
Call your agent today for more information on the Blues wellness products today!
Thank you for your continued association participation.
Need a duplicate ID card? Order it through our website: www.association-benefits.com
Health Benefit Options For: Employees’ Dependents (ages19-25)
BCBSM is in the process of preparing their annual
Family Continuation (FC) member list, which identifies groups with dependents who will turn age 19, by December 31, 2007. You will receive information specific to your group in November.
Dependents currently covered under Family Continuation who reach age 25 in 2007: These dependents will automatically be terminated at midnight December 31, 2007. These dependents are eligible for COBRA benefits, as well as group conversion to the BCBSM plans listed below ( #2 - 4 only).
Dependents who reached age 19 in 2007: Without any action from the employee, these dependents will be terminated, effective at midnight on December 31, 2007. However, there are three alternate options that an employee should consider:
- Family Continuation Rider,
- Young Adult BlueSM plan,
- Individual Care BlueSM PPO plan, or
- Flexible BlueSM HSA plan
1. Family Continuation (FC) Riders allow the dependents to keep the same benefits. FC Riders are available, at an additional charge, for dependents that are between the ages of 19 and 25, if they meet certain criteria. To retain coverage for 19-year-old dependents, employees must complete an Enrollment Change of Status Form.
2. Young Adult BlueSM is designed for single individuals from the age of 19 through 30 years of age. For less than $50 a month, Young Adult Blue coverage includes:
► Affordable co-payments with the option of a Traditional or PPO plan design,
► A $1000 deductible with a 30 percent co-paymentfor covered services rendered in-network,
► Choice of providers from the BCBSM statewide networks-100 percent of Michigan hospitals and 95 percent of physicians participate with Young Adult Blue,
3. & 4. Individual Care BlueSM PPO and Flexible BlueSM HSA are age rated plans designed for both individuals and families. Coverage includes:
► For Individual Care BlueSM PPO , you will receive Physician and hospital coverage with no deductible and 30 percent in-network co-payment for covered services,
► For Flexible BlueSM HSA, you will receive Physician and hospital coverage with your choice of a $1500 or $2500 deductible. The $1500 deductible plan has no in-network copay for covered services. The $2500 deductible plan has a 20 percent in-network co-payment for covered services,
► Both Individual Care BlueSM PPO and Flexible BlueSM HSA offer prescription drug coverage with a $2,500 maximum annual benefit after deductible,
► Both Individual Care BlueSM PPO and Flexible BlueSM offer choice of providers from the BCBSM statewide networks – 100 percent of Michigan hospitals, 95 percent of physicians and 98 percent of pharmacies,
Contact your agent today for more information.
*Specific eligibility requirements apply for each plan.
REMINDER: Annual Medicare Part D "Notice of Creditable Coverage"
If your company offers a prescription drug plan to Medicare-eligible employees or any Medicare-eligible dependent, the Centers for Medicare & Medicaid Services (CMS) requires you to send a Notice of Creditable Coverage to all those members each year.
This is important as we approach the Open Enrollment period for Medicare (November 15 - December 31).
CMS defines “creditable coverage” to mean that the employer’s drug plan is “as generous as, or more generous than” the standard coverage under the Medicare Part D prescription drug benefit. In other words, the expected value of claims paid under your plan is as much as the value of claims that would be paid under the standard Medicare Part D benefit.
CMS also requires that you notify them within 90 days after you have completed your annual Notice of Creditable Coverage. This is known as your “disclosure notice” and the only way to submit it is via the CMS website. You are required by the CMS to provide a disclosure notice whenever any change occurs that affects whether your drug coverage qualifies as creditable.
ALL employers that currently provide prescription drug coverage must complete this notification.
If you have specific questions regarding your obligations under Medicare Part D, you should consult with your legal council, tax advisors, and/or insurance agent, who will be familiar with your business needs.
For more information, visit the CMS Website.